Transition – By Olly Double


Last Tuesday, Tom had his last appointment at the children’s diabetes clinic. His older brother Joe moved on to the transition clinic a while ago and now Tom’s following him. This is a significant moment, because the children’s clinic has been a big thing for all of us. Joe and Tom have been looked after by an amazing team, led by a doctor whose brilliance is matched by his affability. It’s great to come across somebody so eminent who has no airs and graces, but chats and jokes in such a way that everybody instantly relaxes. I know the transition clinic will be good too, but I can’t help feeling sad at leaving the old one behind – not least because I couldn’t be there for Tom’s final appointment.

I suppose part of what’s getting to me is that bittersweet feeling of seeing our kids grow up. Joe’s 17 now, and very nearly as tall as me – at least when he’s not slouching. Tom’s 15 and towers over Jacqui. We’re excited and proud to see them grow and develop, but miss the little ones that they used to be. I won’t spoil the mood by pointing out that I also wish they wouldn’t leave quite so much mess lying around.

I can’t escape the fact that they’re getting older, though. When they started at the clinic, Joe was 11 and Tom hadn’t quite turned nine. We’d been at our local clinic since Tom was diagnosed back in December 2000, and over the years we realised that the care the boys were getting might not be the most up-to-date out there. The old team were reluctant to let the boys move off mixed insulin and start using multiple daily injections, and when we asked them about insulin pumps, well, we might as well have been asking them to give the boys their own personal sonic screwdrivers.

We transferred to the clinic at UCLH (University College London Hospitals) in March 2008, and they started both the boys on insulin pumps pretty much straight away. It was a pretty hectic time, supporting Joe and Tom through a stereo pump start. Two lots of basal rates to play with, two lots of bolus ratios to sort out, and two lots of blood glucose tests to do every hour through the day and night of the first couple of days. By the end of that, the bags under my eyes were such that I swear I could have passed for a bloodhound.

Nonetheless, once things had settled down, we suddenly found that for the first time since type 1 diabetes came into our lives, some sense of order and control had finally come back. Of course, we still get blood sugars that are low or high, but the difference is that when they come along, we tend to have more of an idea why they’ve happened. Not only that, but when they do go all hyperglycaemic on us, it tends to be the low teens rather than the high twenties. Also, it’s much nicer giving insulin with a couple of presses of a button rather than all that palaver with needles.

Since they started pumping, I’ve found that diabetes has made fewer and fewer demands of me. The boys change their own infusion sets now, put their own CGMS sensors on, give themselves boluses, all of that stuff. I’ve always been worse at the whole diabetes rigmarole than Jacqui, but now I’m definitely the worst in the family. I’ve fallen out of practice at most of the things, and there’s no way I could do a set change now without somebody telling me what to do.

I should be grateful of course, but there’s part of me that feels guilty for doing less for them, and there’s even part of me that misses taking the responsibility. Jacqui and I have been doing diabetes stuff for nearly 14 years now, from gently agitating mixed insulin until it becomes a uniform milky colour – to night time testing – to analysing CGMS downloads. Gradually letting go of all that just highlights the fact that we’re starting to let go of the boys themselves. This time next year, Joe will be getting ready to go off to university. He’ll be a young man – inescapably not a boy any more – and leaving home to make his own way in the world. The part we’ll play in his life after that point will, of necessity, be much, much smaller. In just over three years, they’ll BOTH be gone. Gulp!

With all of that in mind, the fact that I managed to miss Tom’s last appointment at the children’s clinic last week makes me feel just a bit hollow inside.

Still, we’ll always be grateful for what they’ve done for our boys.

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